Background: This study was conducted to investigate the effect of
pneumonectomy after neoadjuvant therapy on survival, morbidity,
and mortality in patients with non small cell carcinoma (NSCLC).

Methods: Files of 130 patients who were performed pneumonectomy
in our clinic for NSCLC between November 1995 and August 2012
were retrospectively reviewed. Patients with other malignancies
and/or distant metastasis, and who underwent completion
pneumonectomy were excluded, and the remaining 116 patients
(113 males, 3 females; mean age 57 years; range 31 to 82 years)
constituted the study group. Neoadjuvant treatment was administered
to 47 patients (group 1) who had advanced stage (T3-4N0-1 or
T1-3N2) NSCLC. Pneumonectomy without neoadjuvant treatment
was performed in 69 patients with T2-4N0-1 (group 2). Survival,
morbidity, and mortality rates were compared between the groups.

Results: Sixty-two patients (53%) underwent left pneumonectomy.
The median length of hospital stay was 6.4 days (range 1-33
days). Chemotherapy was administered in 29 patients (62%),
and chemoradiotherapy in 18 patients (38%) preoperatively. Left
pneumonectomy was performed in 29 patients after neoadjuvant
treatment. Complications were detected in 31% of patients (group 1:
28%, group 2: 33%). Ninety-day mortality rate was 4.2% in group 1,
and 5.8% in group 2. Five-year-survival rate was 41% and 35%
for group 1 and group 2, respectively. Median survival time was
41 months and 40 months for group 1 and group 2, respectively.
No statistically significant difference was detected between the two
groups in terms of morbidity, mortality, and survival.

Conclusion: This study showed that pneumonectomy after
neoadjuvant treatment may be safely administered in patients with
locally advanced NSCLC with acceptable morbidity, mortality, and
survival rates.

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